This is a question that brings many patients into our clinics feeling anxious about what’s happening in their mouth. I’m Dr. Emily Nguyen, Principal Dentist at Picasso Dental Clinic, and after treating over 70,000 patients since 2013, I’ve learned that recognizing these warning signs early can save your tooth and prevent serious complications.
Sign One: Persistent and Severe Tooth Pain
The most telling symptom is tooth pain that doesn’t go away. I’m not talking about brief discomfort after eating something cold, but rather deep, throbbing pain that disrupts your daily life. This pain often intensifies when you lie down or bend over because the increased blood flow to your head puts pressure on the infected nerve.
What I tell patients is that healthy teeth shouldn’t hurt spontaneously. If you find yourself taking painkillers multiple times daily or waking up at night because of tooth pain, the nerve inside your tooth is likely infected or dying. At our Hanoi and Ho Chi Minh City clinics, approximately 60% of root canal patients describe this exact pattern of pain.
The pain might seem to move around your jaw or radiate to your ear, which confuses many patients about which tooth is the problem. During examination, I use specific tests to identify the culprit tooth, even when you can’t pinpoint it yourself.
Sign Two: Prolonged Sensitivity to Temperature
Brief sensitivity to cold drinks is normal, but if the sensation lingers for 30 seconds or more after removing the hot or cold stimulus, your tooth’s nerve is compromised. I’ve found that sensitivity to heat is particularly concerning because it often indicates the nerve is dying and creating gases inside the tooth that expand with warmth.
Many patients at Picasso Dental Clinic describe avoiding entire categories of food and drink. You might stop drinking coffee, avoid ice cream, or eat only on one side of your mouth. This progressive avoidance is your body telling you something’s wrong.
What distinguishes root canal sensitivity from regular sensitivity is the intensity and duration. General sensitivity responds well to sensitive toothpaste and affects multiple teeth. Root canal sensitivity focuses on one tooth and feels like a sharp, lingering ache that makes you wince.
Sign Three: Gum Swelling and Tenderness
When infection spreads from your tooth’s root into the surrounding bone and gum tissue, you’ll notice swelling. The gum near the problem tooth might feel puffy, tender to touch, or even show a small bump that looks like a pimple. We call this a fistula, and it’s your body’s attempt to drain the infection.
Sometimes this bump releases pus, which temporarily relieves pressure and pain. Patients tell me they feel better after this happens and assume the problem resolved itself. The infection is still there, just draining periodically. I’ve treated patients at our Da Nang clinic who lived with these draining bumps for years before seeking treatment.
The swelling can extend to your face or neck in severe cases. If you notice facial swelling accompanied by fever, this constitutes a dental emergency requiring immediate attention at any of our four clinic locations.
Sign Four: Tooth Discoloration
A tooth that’s turning gray, dark yellow, or brownish is showing visible evidence of nerve death. The discoloration happens because the dying nerve tissue and blood break down inside your tooth, staining it from the inside out. This sign is particularly common with front teeth where the color change is obvious.
I’ve had patients at Picasso Dental Clinic mention they thought the discoloration was just surface staining from coffee or tea. External stains can be polished away during cleaning, but internal discoloration from nerve death cannot. When I see a single tooth that’s noticeably darker than its neighbors, a root canal is often necessary.
The color change usually develops gradually over weeks or months. Some patients only notice when comparing current photos to older ones. Once you see this discoloration, the nerve has likely been dead for some time.
Sign Five: Pain When Chewing or Touching the Tooth
If biting down or touching a specific tooth causes sharp pain, the infection has likely spread to the ligaments and bone surrounding your tooth’s root. This symptom often appears after the other signs and indicates the infection is progressing.
Patients describe avoiding certain foods or chewing only on the opposite side of their mouth. You might unconsciously protect that tooth during meals. At our clinics across Vietnam, I use percussion tests during examinations, gently tapping teeth to identify which one responds with pain.
The pain when biting results from inflammation around the root tip, not just the infected nerve inside. This means the infection has moved beyond the tooth itself, making prompt treatment even more important to prevent bone loss.
What Happens If You Ignore These Signs
I’ve seen patients delay treatment for months or even years, hoping the symptoms will disappear. Dental infections don’t resolve on their own. The infection spreads, creating abscesses that can affect your jawbone, sinuses, or in rare cases, enter your bloodstream.
The tooth becomes increasingly difficult to save as time passes. What might have been a straightforward root canal can progress to requiring extraction and implant placement, which costs significantly more and takes longer to complete. Since 2013, I’ve treated countless patients who wished they’d come in earlier when symptoms first appeared.
If you’re experiencing any of these five signs, schedule an examination at Picasso Dental Clinic in Hanoi, Da Nang, Ho Chi Minh City, or Da Lat. Early root canal treatment has a success rate exceeding 90% and can save your natural tooth for decades to come.
